The medicine perioperative includes anesthesia, treatment of acute pain, obstetrical work, surgical intensive care, CPR, emergency medicine and trauma care.
The Medicines for You
The value-based medicine is the process of systematically search of modern studies, evaluate and use their findings to develop clinical decision bases. Thus perioperative value-based medicine deals with the development of rational decisions in perioperative medicine: what should be recommended to patients? What interventions should be carried out? What are the research priorities?
For the past 20 years or pharmaceutical value based selling) is considered a central element in the teaching of medicine. It corresponds to an evolution of medical practice towards a model putting emphasizes the importance in clinical decision-making of rigorous value and systematic results from medical research, in conjunction with the values and patient preferences. However, many uncertainties accompany this concept. His application and its perception vary from one country to another and according to the specialties medical. This thesis, while aiming to paint a most comprehensive picture possible of the question, also partly reflects these divergent views.
The Chapters for You
The first chapter introduces the concept of EBM by retracing its history and development in the last twenty years, describes the different components and challenges of its teaching, then draws up an inventory of its application in France. EBM is consists of five stages, each of which should be addressed in teaching: (i)know how to formulate the problem into concrete questions; (ii) find the best value for answer these questions; (iii) critically examine this scientific data; (iv)apply the results of this critical review in clinical practice; (v) evaluate his performance. In practice, the third part is the most widely taught. AT different levels, the official program of education provided in the Faculties of Medicine in France deals with themes linked to training in EBM, but the quantity and quality of this education are unequal. Few Faculties provide specific teaching; these initiatives were listed by a short survey.
The Second Chapter
The second chapter aims to describe the perceptions by students in Medicine, Evidence-based medicine (EBM). A systematic review of the literature has been carried out with interrogation of the PubMed, Embassy and Google Scholar databases. Eight studies have been included. The EBM and its teaching were perceived positively by the students. They felt that their knowledge and skills, especially for research documentary and critical appraisal of information were improved. The clinical teachers using EBM principles in their practice were a factor of appropriation.
EBM was seen as a way to update one’s knowledge medical. In total, there is a vast literature on EBM but its perception by medical students has been little studied. The teaching of EBM should be interactive, integrated into clinical practice. The role of role model of teachers should be taken into account for a better appropriation of EBM by the students. The third chapter deals with the question of the centers of value, on a general level, by analyzing the interest of local centers. The specificities of EBM and the establishment of a proof center for two distinct medical specialties: radiology and endocrinology.